Neurology

Question 1

What are the features of Erbs palsy?

Answer 1

• Result of birth trauma, breech delivery, cesarean section, clavicle fractures, LGA births
• Brachial plexus injury at C5-7
• Paralysis of upper arm
• Unilateral diaphragmatic paralysis in about 5% of cases
• Waiters tip: can grasp the money you give him

Question 2

What are the features of Klumpke palsy?

Answer 2

• Brachial plexus injury C8-T1
• Paralysis of lower arm
• Cannot grasp
• Associated with Horner’s syndrome: ptosis, miosis, anhydrosis

Question 3

What are the features of Guillain-Barré syndrome?

Answer 3

• Ascending paralysis
• Associated with fever
• Acute inflammatory demyelinating polyneuropathy
• Diminished or absent reflexes in the lower extremities
• Sensation is preserved
• Bowel and bladder continence are preserved
• Increased CSF protein without an increase in WBC’s

Question 4

What are the features of tick paralysis?

Answer 4

• Clinical picture similar to Guillain-Barré syndrome
• Acute ascending paralysis
• Absent reflexes

Question 5

What are the features of Todd paralysis?

Answer 5

• Focal motor weakness after a seizure

Question 6

What are the features of dandy walker malformation?

Answer 6

• Dandy Walker Syndrome = DWS = Dilated 4th ventricle, Water on the brain (hydrocephalus), Small vermis

Question 7

What is PHACES Syndrome?

Answer 7

Posterior fossa malformation (DANDY WALKER)
Hemangioma
Arterial cerebrovascular anomaly
Cardiac anomalies: Coarctation of the aorta
Eye anomalies: Micropthalmia, strabismus
Sternal defect

Question 8

What are the features of ataxia telangiectasia?

Answer 8

ATAXIA

A: ataxia (cerebellar)
T: telangiectasias
A: AFP elevated
X: visual motor disturbances 
I: immune deficiency 
A: abnormal cognition and neuro

• Increased risk of malignancy in 3rd decade

Question 9

What are the features of Friedreich ataxia?

Answer 9

• Child become slow and clumsy around the time of puberty
• Ataxia due to degeneration of nerve fibers in the spinal track -> loss of proprioception
• Diabetes mellitus
• Congestive heart failure from myocardial fiber degeneration
• High plantar arch

Question 10

What are the features of an upper motor neuron disease?

Answer 10

• Hyperactive reflexes
• Increased muscle tone
• No fasciculations
• Positive Babinski reflex (upward going toes)

Question 11

What are the features of an epidural hematoma?

Answer 11

• Rapid decline in mentation after a lucid period

- Arterial bleeds: require immediate surgical intervention

Question 12

What are the features of a subdural hematoma?

Answer 12

• Caused by shearing of bridging veins between the dural sinuses
• Associated with high speed acceleration or deceleration
• Mental status changes may be fast or slow in onset
• No lucid period
• Evacuate bleed if they show increased intracranial pressure or if they are increasing in size

Question 13

What are the features of a subarachnoid hemorrhage?

Answer 13

• Sudden and extremely painful headache